A Survey of Australian Healthcare Practitioners' Perspectives on Goal Setting in Occupational Rehabilitation

Nearly half a million Australians experience workplace injury or illness each year, and return-to-work rates have declined, particularly for psychological conditions. Practitioners use goal setting to structure return-to-work planning and are directed by national guidance to set SMART (Specific, Measurable, Achievable, Realistic, Time-bound) goals. How practitioners apply these criteria across different injuries and illnesses is not well understood. This study examined practitioners' perspectives on goal setting in workers' compensation rehabilitation in Australia, with a focus on SMART goals.

A cross-sectional online survey of Australian healthcare practitioners who treated physical conditions, psychological conditions, or both, was conducted. Quantitative data were analysed using descriptive statistics and chi-squared tests, and open-text responses were analysed using content analysis.

154 practitioners across 12 professions completed the survey. Goal setting was considered highly or extremely important (71.4%) and used with most clients (74.0%), although nearly a third of practitioners (36.6%) did not name the client amongst those who set the goals. The majority of participants were familiar with SMART goals (87.5%), used them confidently (88.7%), and considered them best practice (75.7%), with open-text responses indicating participants valued their structure and clarity. Over a quarter of responses exploring challenges with SMART goals identified concerns when using SMART for clients with psychological injuries, describing rigid timeframes and measurability elements as counterproductive. Respondents also identified the need for clinical flexibility in complex cases, whilst noting that documentation and stakeholder expectations reinforced the use of SMART goals. Perspectives were largely consistent across professions and injury types.

Practitioners generally endorsed SMART goals but raised concerns about their applicability for clients with psychological injuries, the group with the lowest return-to-work rates in Australia. Further work is needed to determine how goal setting in workers' compensation rehabilitation can accommodate these clinical needs.